Provider Demographics
NPI:1659187698
Name:DINGLE, NATACHIA (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:NATACHIA
Middle Name:
Last Name:DINGLE
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12126 LEMMOND FARM DR APT 2508
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-8307
Mailing Address - Country:US
Mailing Address - Phone:704-779-1209
Mailing Address - Fax:
Practice Address - Street 1:12126 LEMMOND FARM DR APT 2508
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-8307
Practice Address - Country:US
Practice Address - Phone:704-779-1209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006625133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered